WO2001054604A1 - Bipolares fassinstrument - Google Patents
Bipolares fassinstrument Download PDFInfo
- Publication number
- WO2001054604A1 WO2001054604A1 PCT/EP2000/011052 EP0011052W WO0154604A1 WO 2001054604 A1 WO2001054604 A1 WO 2001054604A1 EP 0011052 W EP0011052 W EP 0011052W WO 0154604 A1 WO0154604 A1 WO 0154604A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- clamping
- gripping
- jaws
- cutting
- cutting element
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
Definitions
- the invention relates to a bipolar barrel instrument with two mutually movable, elastically isolated clamping jaws, each of which can be connected to a pole of an electrical high-frequency voltage source, each of which has two clamping elements which are arranged at a distance from one another and form a longitudinal slot, each with a clamping surface, and with a cutting device, which comprises a cutting element displaceable in the longitudinal slot of the clamping jaws with a cutting edge.
- the jaws of the barrel instrument are divided into two adjacent clamping surfaces by longitudinal slots, and a cutting element provided with a cutting edge can be inserted into the longitudinal slots in the longitudinal direction of the instrument, which cuts through tissue parts held between the clamping surfaces after coagulation.
- a cutting element provided with a cutting edge
- different drive mechanisms must be provided for closing the clamping jaws for the purpose of coagulating and for advancing the cutting element of the cutting device, this instrument, which is preferably designed as a tubular shaft instrument, is thus relatively complicated, and the user of this instrument must also have two separate ones Use drive mechanisms to sequentially grasp tissue and then cut it.
- the cutting element is thus received in the longitudinal slot of the one clamping jaw so that the cutting edge of the cutting element is located inside the longitudinal slot and is therefore not effective.
- the instrument acts like a conventional bipolar grasping instrument, in which the clamping surfaces are applied to the tissue to be gripped without the cutting element even appearing.
- the bipolar barrel instrument can also be removed after the coagulation like a conventional bipolar barrel instrument.
- both the cutting element and the clamping elements are formed in one piece with the clamping jaws and that the cutting element is a rigid part of the clamping jaw, while the clamping elements are connected to the remaining parts of the clamping jaw via elastically deformable regions.
- the elastically deformable regions can be formed by elastically bendable webs with a lower height.
- the clamping jaw is formed in two parts with a rigid first part, which comprises the cutting element and the mounting of the clamping jaw on the barrel instrument, and with a second part, which comprises the clamping elements and which is elastically movably mounted on the first part ,
- the clamping elements can be elastically pivoted on the first part.
- the second part is U-shaped with two parallel legs that form the clamping elements and a connecting bar that connects the longitudinal slot to the distal end of the jaw, and if the second part is rotatable on the free ends of the legs on the first part is stored. This results in a very stable arrangement of the second part of the clamping jaw carrying the clamping surfaces.
- the longitudinal slot in the other clamping jaw which has no cutting device, is preferably closed at both ends, so that the cutting device is immersed in the all-round closed longitudinal slot during the cutting process, and this also contributes to the fact that the other clamping jaw forms a very stable arrangement.
- FIG. 1 a side view of a bipolar barrel instrument designed as a tubular shaft instrument with two pivotable clamping jaws;
- Figure 2 is an exploded perspective view of the two jaws and the drive elements for the jaws
- Figure 3 a side view of the instrument. 1 in the jaw area with the jaws in a gripping position;
- Figure 4 a view similar to Figure 3 with the
- Figure 5 is a perspective view of the clamping jaw provided with a cutting device similar to the illustration of Figure 2 in a modified embodiment of this jaw.
- the surgical instrument shown in the drawing is designed as a tubular shaft instrument 1 with an elongated, tubular shaft 2 with a distal end 3 and a proximal end 4.
- the shaft 2 is connected to a grip part 5, which comprises a fixed branch 6 and a branch 7 pivotally connected to it, which is connected in an articulated manner to a push and pull rod 8 which passes through the shaft 2 and is pivoting of the branch 7 relative to the shaft 2 can be advanced and retracted in the longitudinal direction.
- a grip part 5 which comprises a fixed branch 6 and a branch 7 pivotally connected to it, which is connected in an articulated manner to a push and pull rod 8 which passes through the shaft 2 and is pivoting of the branch 7 relative to the shaft 2 can be advanced and retracted in the longitudinal direction.
- a holder 9 is inserted into the shaft 2, which carries at its distal end two parallel bearing arms 10 which project in the distal direction and enclose a bearing intermediate space 11 between them.
- the pull and push rod 8 passes through both the holder 9 and the insulation body 12 and ends in the area of the intermediate space 11 in the bearing.
- the bearing arms 10 In the region of their free ends, the bearing arms 10 have receiving openings 13, which are aligned with one another, for a bearing shaft 14 which runs transversely to the longitudinal direction of the longitudinal axis of the shaft of the instrument and penetrates the intermediate space 11 at its distal, open end.
- two clamping jaws 15, 16 are mounted next to one another and pivotable independently of one another, the proximal ends 17, 18 of which protrude into the intermediate space 11 in the bearing.
- Each proximal end 17, 18 is articulated to a link 19 or 20, the other ends of which are also articulated to the distal end of the push and pull rod 8, so that these links 19, 20 together with the proximal ends 17 and 20 18 form a four-bar linkage, by means of which the clamping jaws 15 and 16 can be pivoted about the axis of rotation formed by the bearing shaft 14 when the pushing and pulling rod 8 is pushed in and pulled back:
- the clamping jaws When the pushing and pulling rod 8 is pushed in, the clamping jaws are pivoted apart; H. open, when the push and pull rod 8 is withdrawn, the clamping jaws 15, 16 are closed.
- the jaws 15 and 16 are designed differently.
- One of the two clamping jaws, hereinafter referred to as the lower clamping jaw 16, is constructed in three parts and comprises a proximal section 21, which extends extends directly in front of the bearing shaft 14, a central section 22, which is located essentially in the region of the bearing shaft 14, and a distal section 23, the essentially flat top side 24 facing the other clamping jaws 15, which forms a clamping surface which increases the Grip is provided with cross ribs 25.
- the middle section 22 consists of an electrically insulating material, for example ceramic, and connects the proximal section 21 to the distal section 23 with electrical insulation of these two sections, which are made of metal and are therefore electrically conductive.
- the middle section 22 lies flat against both the distal section 23 and the proximal section 21, so that a layer structure is formed in the overlap region, and the middle section 22 is supported on the proximal section 21 via its rear edge 26 and via a front contact surface 27 or on the distal section 23, so that in this way the proximal section 21 is electrically insulated and rigidly connected to the distal section 23.
- the middle section 22 laterally carries a sleeve 28 formed integrally with it, which passes through the bearing openings 29 and 30 in the two clamping jaws 15 and 16 and which accommodates the bearing shaft 14, which is thereby opposite the clamping jaw 15 and the proximal end 18 of the Clamping jaw 16 is electrically insulated.
- the bearing shaft 14 itself is made of metal and is electrically conductively connected to the bearing arms 10 of the holder 9, which in turn are electrically conductive Connected to the shaft 2. This carries an electrical connection 31, with which an electrical connection to a high-frequency voltage source, not shown in the drawing, can be established.
- the bearing shaft 14 is in direct contact with the distal section 23 of the clamping jaw 16, so that an electrically conductive connection between the distal section 23 and the bearing shaft 14 is formed in this area.
- the distal section 23 of the clamping jaw 16 can be connected to a pole of the high-frequency voltage source.
- the other pole is connected in a manner not shown in the drawing with the push and pull rod 8, so that in this way both the proximal portion 21 of the jaw 16 and the entire jaw 15 with this second pole of the handlebars 19 and 20 High frequency voltage source are connected.
- the other jaw hereinafter referred to as the upper jaw 15, is made entirely of metal and is in the embodiment of Figures 1 to 4 integrally formed.
- a proximal section 34 is configured similarly to the proximal section 21 of the lower clamping jaw 16, it merges into a distal section 35 which has two clamping elements 37 which run parallel to one another and form a longitudinal slot 36 between them and are of identical design.
- Both clamping elements 37 each have a clamping surface 38 on their side facing the lower clamping jaw 16, which faces the clamping surface 24 of the lower clamping jaw 16 and which, like this, is provided with transverse ribs 39.
- Both clamping elements 37 are connected to the proximal section 34 by means of band-shaped webs 40 of low overall height, which are so flat that an elastic pivoting of the arm-like clamping elements 37 is possible in this area, specifically about a pivot axis that runs parallel to the bearing shaft 14.
- a cutting body 41 which is rigidly connected to the proximal section 34 and projects into the longitudinal slot 36 remaining free between the two clamping elements 37, the lower edge of which is designed as a cutting edge 42. If the clamping elements 37 are undeformed, that is if they are not pivoted elastically with respect to the proximal section 34, the cutting edge 42 is located completely inside the longitudinal slot 36, i.e. it does not project downward over the clamping surfaces 38 of the two clamping elements 37 (illustration of FIG Figures 2 and 3).
- a longitudinal slot 43 is also formed, which is aligned with the longitudinal slot 36 in the upper jaw 15 and which is closed at both ends, the length of the longitudinal slot 43 is dimensioned such that the cutting edge 42 of the cutting body 41 is immersed in the longitudinal slot 43 can.
- the instrument designed in this way serves both as a bipolar barrel instrument and as a cutting instrument.
- tissue to be treated for example a vessel 44
- tissue to be treated for example a vessel 44
- the vessel 44 can be coagulated in the contact area in the contact area, as is known per se in the case of bipolar grasping forceps, by placing the vessel on the two clamping jaws 15 and 16.
- This coagulation takes place when the jaws 15, 16 are in a position in which they are pivoted into an intermediate position relative to the open position, but are not yet completely closed.
- the contact pressure of the upper jaw 15 to the vessel 44 be so small that the clamping elements 37 are not pivoted elastically in the region of the webs 40, but remain undeformed, so that the cutting body 41 remains with the cutting edge 42 in the longitudinal slot 36, so the cutting edge 42 is ineffective (FIG 3).
- the two clamping elements 37 are not connected to the proximal section 34 of the clamping jaw 15 via elastic webs 40, but are pivotably mounted on the cutting body 41 via a bearing pin 45, specifically in the transition region of the cutting body 41 to the proximal section 34
- the distal ends of the clamping elements 37 are connected to one another by a cross bar 46, so that the two clamping elements 37 form a unitary component together with the cross bar 46.
- a spring element 47 which is shown only schematically in the drawing and is connected on the one hand to the cutting body 41 and on the other hand to the transverse web 46, holds the clamping elements 37 in a position in which the clamping surfaces 38 project downward over the cutting edge 42 of the cutting body 41, that is to say the cutting edge 42 completely received in the longitudinal slot 36 and is therefore ineffective.
- the clamping elements 37 can be pivoted elastically so that the cutting edge 42 emerges from the longitudinal slot 43 and becomes effective in the manner described.
- the clamping elements 37 are electrically conductive with the bearing pin 45 proximal portion 34 connected, so that in this case, the clamping surfaces 38 are connected to a pole of the high-frequency voltage source.
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Otolaryngology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP00978976A EP1250102B1 (de) | 2000-01-25 | 2000-11-09 | Bipolares fassinstrument |
AT00978976T ATE243004T1 (de) | 2000-01-25 | 2000-11-09 | Bipolares fassinstrument |
JP2001555584A JP3691793B2 (ja) | 2000-01-25 | 2000-11-09 | 双極式把持器具 |
US10/199,739 US6743230B2 (en) | 2000-01-25 | 2002-07-18 | Bipolar grasping instrument |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10003020.3 | 2000-01-25 | ||
DE10003020A DE10003020C2 (de) | 2000-01-25 | 2000-01-25 | Bipolares Faßinstrument |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/199,739 Continuation US6743230B2 (en) | 2000-01-25 | 2002-07-18 | Bipolar grasping instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2001054604A1 true WO2001054604A1 (de) | 2001-08-02 |
Family
ID=7628616
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2000/011052 WO2001054604A1 (de) | 2000-01-25 | 2000-11-09 | Bipolares fassinstrument |
Country Status (7)
Country | Link |
---|---|
US (1) | US6743230B2 (ja) |
EP (1) | EP1250102B1 (ja) |
JP (1) | JP3691793B2 (ja) |
AT (1) | ATE243004T1 (ja) |
DE (1) | DE10003020C2 (ja) |
ES (1) | ES2200975T3 (ja) |
WO (1) | WO2001054604A1 (ja) |
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Also Published As
Publication number | Publication date |
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US20020183784A1 (en) | 2002-12-05 |
DE10003020A1 (de) | 2001-08-23 |
US6743230B2 (en) | 2004-06-01 |
ATE243004T1 (de) | 2003-07-15 |
JP3691793B2 (ja) | 2005-09-07 |
ES2200975T3 (es) | 2004-03-16 |
EP1250102B1 (de) | 2003-06-18 |
JP2003521304A (ja) | 2003-07-15 |
EP1250102A1 (de) | 2002-10-23 |
DE10003020C2 (de) | 2001-12-06 |
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